Provider Demographics
NPI:1225335656
Name:MARIAC ENTERPRISES, LLC
Entity Type:Organization
Organization Name:MARIAC ENTERPRISES, LLC
Other - Org Name:BRIGHTSTAR CARE OF MARIETTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-290-7827
Mailing Address - Street 1:833 CAMPBELL HILL ST NW
Mailing Address - Street 2:SUITE 116
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1134
Mailing Address - Country:US
Mailing Address - Phone:678-290-7827
Mailing Address - Fax:678-290-7817
Practice Address - Street 1:833 CAMPBELL HILL ST NW
Practice Address - Street 2:SUITE 116
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1134
Practice Address - Country:US
Practice Address - Phone:678-290-7827
Practice Address - Fax:678-290-7817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-21
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-0452251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health